A startup aims to help the 18 million US men diagnosed with erectile dysfunction pay attention to their 'check-engine light'

Roman, a men's-health startup, connects men with doctors who can prescribe erectile-dysfunction medication.

The hope is that by making the medication more easily accessible, men will start interacting with doctors more frequently than they already do.

Erectile dysfunction, Roman CEO Zachariah Reitano said, is a good "check-engine light" for other health conditions a man might be facing.

Roman's office looks just like any other startup's setup. There are a few rows of desks, an office dog (Thor), and a little pharmacy stocked with the branding you've come to know from startups: clean, simple color schemes packed up in personalized boxes.

But the first sign this isn't just another startup is what's inside the boxes: erectile-dysfunction medications.

Roman is a men's-health company that launched in November with $3 million in seed funding led by General Catalyst. It has both a telemedicine practice and a pharmacy that's able to distribute medications specifically for erectile dysfunction, such as Viagra and Cialis.

It's uncommon to encounter a pharmacy that just distributes one particular kind of medication. Why this medication? It's a way to get more men to see the doctor. Men are half as likely to go see a doctor regularly as women are, so preventing certain diseases might be a bit more challenging.

An estimated 18 million men in the US are diagnosed with ED, and Viagra alone has consistently generated $1 billion in sales every year since 1999. That would make it seem as if it's relatively easy to get treated for ED.

Roman CEO Zachariah Reitano says the answer is not quite so clear. Sure, it might be simple to ask, "Is the plumbing working?" After that, things get more complicated.

"But then saying something to the effect of, 'When you masturbate, are you able to maintain and achieve an erection for the entire time?'" Reitano said. "If someone says 'no,' then you say, 'OK, well at what point does it start to decrease, how are you thinking about it, what did you do today? Did you wake up with an erection, if so, how hard?' All these things are, while you'd like to think that they're solely clinical, it's tough for people to explain in detail."

It's a different situation when it's by phone or computer.

"On their couch, or in their home on a computer, they will write endlessly," Reitano said.

Roman's pharmacy in its office in New York's Flatiron district. Lydia Ramsey/Business Insider

Here's how it works

Patients can go to Roman's website and fill out an online visit with questions about your health, lifestyle, and symptoms.

That visit will get analyzed and sent to a physician, who can help determine what care that patient might need next, especially if that's an actual visit to a doctor's office.

If the person is a good fit for Roman, that patient will work with a physician in his state over the phone. That physician can help get the patient a prescription for the ED medication, if that's the best treatment plan.

That prescription can either be placed to the patient's pharmacy or shipped to them in a discrete brown box. Inside, the pills come individually packaged based on the patient's dosage.

After that, the doctor will work with the patient on his overall health, trying to figure out the underlying cause of the ED, whether it's psychological, based on other health conditions, or changes needed in a person's diet and exercise.

Roman

A 'check-engine light' for men's health

"The strength of a man's erection is a great indicator for their overall health," Reitano said. "If you go into a doctor's office and cover up that check-engine light, everything else might look OK. But that information is also super important for your doctor to hear, because that triggers something in them that, 'OK, this is the very start, and we don't want this to snowball.'"

Reitano said that ED could be a good motivator to get those health problems under control to a point where they no longer need the medication in the first place.

"From a patient's perspective, there's two great days: the first is when they get treatment and are able to have that part of their life again. And the second is when they no longer need it," Reitano said. He compares the ED medications to a knee brace, which ultimately is there to help people heal and start moving normally again.

"If you can't help someone with that immediate part of their life, it's hard for them to think about taking on the root issue," Reitano said.

Reitano said the hope for Roman is to take on that "day two" by helping people figure out the lifestyle changes they might need to take to treat erectile dysfunction, whether that be quitting smoking, working out more, or eating better. The plan is to expand the pharmacy services beyond ED medications as well, based on what patients need to treat those more underlying conditions, like high cholesterol or diabetes.

"It is definitely our goal to increase the top of the funnel and make sure as many men as possible enter the healthcare system and then we work toward our future conditions that treat the underlying causes," Reitano said.